Make It a Masterpiece

Sunday, May 06, 2018

The President is going to tackle the healthcare system with a focus on prescription drug prices. What does that mean? Secretary of Health and Human Services Alex Azar says, "I believe we can lower the cost of medicine while still promoting research that will transform the future of health care going forward. Doing both is the only way forward."

Those are important words to me.

When I was diagnosed with a cancer of cells in the bone marrow called multiple myeloma, I was given three to five years to live. That was back in 2003! Thanks to medical advances I have moved past that prognosis – no, I have literally run past that prognosis.

I began running marathons when I was diagnosed, to have an activity I could do with my family. After running one marathon, I decided to try to qualify for the famed Boston Marathon and then just kept running. In November 2016 I completed 100 marathons, including one in each of the 50 states, running with cancer while on treatment. Now I have a new goal. I am trading speed for distance, and will try to qualify for the National Senior Games that take place in 2019 in New Mexico.

To get to this point in my life, I’ve depended on medical progress. First a pill to keep my cancer in check, and recently I had to add a second medication to my regimen. Neither treatment was available when I was first diagnosed. That’s why the words of Secretary Azar are so important to me when he says let’s continue to promote research.

But the President’s focus is on those prescription drug prices. How are we patients going to pay for this progress?

The March 22nd issue of an informative publication called THE COST OF HEALTHCARE NEWS says, “When people talk about high drug costs, they are really talking about high out-of-pocket costs to them under their insurance plan – especially huge open-ended obligations if they become sick with cancer or a debilitating auto-immune or infectious disease.”

The paper supports this assertion with a series of facts that show the cost of medications is not skyrocketing.

Retail prescription drugs account for about one-tenth of total health spending. Hospitals account for one-third of our healthcare spend, and remember, good medications keep people out of hospitals.

According to the Centers for Medicare and Medicaid Services (CMS), pharmaceutical spending rose only 1.3% in 2016 (the most recent year for data)

According to the IQVIA Institute for Human Data Science, most prescriptions ARE reimbursed at affordable rates. “Only 2.3% of all prescriptions cost the patient more than $50.”

I might add that separately, the IQVIA says in 2017, the overall US spending on medications (brand-name and generics) increased just 0.6%.

So why do cancer patients have problems paying for our prescriptions?

First, if you’re like me and you have good insurance, the copays are manageable. For others insurance plans place these specialty medications on high tiers requiring the patients to shoulder the burdens themselves. Yes, these newer medications coming out of years of research and testing are expensive. But The Cost of Healthcare News says “only a tiny slice of the population needs such drugs, and the aim of insurance is to protect such patients against the catastrophe of having to pay for expensive medicines on their own.”

We can afford to provide patients with the coverage we need. One benefits company reports that only 3 out of every 1,000 patients had medical costs exceeding $50,000 a year. A study for the Leukemia and Lymphoma Society shows that if we cap the co-pays, insurance premiums for a typical plan would go up less than three dollars per month.

So as we work to make life-changing prescriptions available to me and my fellow patients, let’s focus on the real target. The newsletter says misdirected proposals “would further block patient access to medicines and deter investment in developing new medicines that save lives.”

That’s why I appreciate Secretary Azar’s comments about “promoting research that will transform the future of health care going forward.” As a cancer patient and a runner, I work with a trainer because it’s risky to just bolt out of the blocks. It’s even more risky if we start running in the wrong direction.

Monday, April 16, 2018

Another run at the local high school indoor track. We have been running there all winter, not using either of the YMCA tracks that are 15 miles away, since this one is just a mile. I like the air in here, and I like everything else about it, including the atmosphere, students and teachers mixing with us ordinary citizens. Best of all, it’s free with Silver Sneakers.

I caught a nasty cold about six weeks ago and didn’t run much for several weeks, but we’ve gone to this track almost very day this month and I’m coming back from that time off. Today I went three miles, running three laps of the first mile, all of the second mile, and three laps of the third. The middle mile took 9:25 and I was speeding up in the last laps, so I could have gone faster. Best finish since the USATF race on March 4. I might be getting back to the running strength that I had before that last cold.

The goal remains the National Senior Games in Albuquerque, in 2019. My preference is to run the 200m dash, but I was injured doing that, and the injured right hamstring tendon just doesn’t seem to heal. Now I have another appointment with the sports doctor, after 9 months, to find out if there is any remedy available besides physical therapy, which just hasn’t worked.

Springtime in Minnesota
The Ides of April Blizzard

In the meantime, or if there is no remedy, I can still run the mile. It’s only about 2/3 as fast (8 times as far) and because of that it doesn’t seem to re-injure me. I run at least a mile every other day, mostly walking on the alternate days, and that doesn’t hurt. I don’t actually LIKE the 1-mile race - it seems very intense. But it’s over in 9 minutes, hopefully less. I can qualify for the Senior Games 1500 meter distance if I can run a mile in 8:20, and I came pretty close at the USATF race.

When we are able to run outdoors, I will increase the distance on some days. In fact there is a popular 10k next weekend, no better way to train than to race. If the streets are open.

Splits: 13:16, 9:25, 12:53, total 35:33 plus a couple of extra laps that I didn’t time.

Saturday, February 17, 2018

A couple of weeks ago I had a good one-mile run at the track, felt fine, but the next day had a serious case of bursitis in the right hip. I couldn’t do much more than walk for most of the next week, but it’s fully recovered now. That mile was 10:27, and I ran another four laps before walking. 54 right turns, maybe the cause of the bursitis.

Last Wednesday, Feb 14 (Valentines Day), I decided to run a bit faster. The track is 9 laps per mile (or so they say), rectangular, around and above four basketball courts. The long sides are maybe twice as long as the short sides, and the corners are pretty sharp and not at all banked. The best way for me to run faster but limit the risk of injury is to speed up on the long sides and maybe a little on the short sides, but slow down for the corners. I did finish in 9:20, which was just fine for Valentines Day, the fastest mile I’ve done on this track. (The track opened last October).

Today I didn’t feel especially strong, but I followed that same procedure, though not pushing too hard, and was a little surprised to finish the first lap in about 61 seconds. Note: 60 seconds per lap is a 9-minute mile. As usual, during the first few laps I tried to think of some excuse to stop and walk, but nothing hurt and I didn’t need to go to the bathroom, so I had to keep going. It gets easier when I’m more than half done and can start counting the laps down instead of up. When there are only three left I look forward to the last two. In the next-to-last lap I see if I can pick up the pace just a little, and that lap seems to go by fairly quickly, and then I feel that I can push to the limit in the last lap, because there is nothing to conserve any more. That’s actually kind of fun.

I must have moved faster in those last two laps because I know that I was slightly behind the 60-second pace somewhere in the middle, but finished the whole mile in 8:57. That’s another new record for me on this track. I really want to run the 200m event, not the 1500, but that is how I got injured. Since I don’t know how to heal the injury, I might as well train for longer instead of faster. A mile is actually 1609 meters, so it’s a good distance for training to run the 1500m track event.

Just a very slight complaint from my right hamstring injury after today’s run. Bend over once to stretch it a little, and it goes away. I’m not sure how to deal with that, actually, but my instinct is to go ahead and bend over, stretch it just that little, so that it will heal correctly.

Mile splits: 13:10, 8:57, ... I failed to record the time of the third mile. Oh well.

Saturday, January 27, 2018

The first lap running on the rectangular track feels very nice, but then somewhere around two laps I’m asking myself “Do I really have to run all nine laps of this mile?" At three it’s getting better, and I’m thinking “good, I’m one third done." At 4 ½ laps it’s “hey, half done.” Then the laps click off more easily and I’m counting them down rather than up, just over a minute apiece. Four laps left, three, two, and I’m wondering if I can just keep going after the ninth lap.

Golly gee, I feel OK at nine laps and keep right on going. Now looking for excuses to stop short of two miles. Do I need to go to the bathroom? Nope - no excuse there. How about pains - does anything hurt? No such luck, still no excuse. Am I at risk of hurting myself? Probably not, but maybe I should only do a mile and a half today just to be safe, and try two miles in a few days.

So I stopped running at a mile and four laps, walking the remaining five laps to finish off the mile. Good run, no pains.

These days I’m walking and running most days that I can. Sunshine and I have been busy with eye surgeries, which are incompatible with running for at least a week afterward, and we have had our share of colds, so I’ve only gotten to the track 14 days so far this month. On the advice of my therapist I don’t run two days in a row, but walking is OK and I walk pretty fast.

I’m still nursing the hamstring tendon injury that first appeared last May, but running the mile doesn’t hurt, at least not at the speed I’m doing now. The plan is to increase distance and speed very gradually, paying close attention to that injury, and travel to several states’ Senior Games track meets over this year, hoping to qualify for the National Senior Games in Albuquerque in 2019. I can already run the 1500m (just short of a mile), and will get faster at that distance. I hope also to be able to run shorter (thus faster) distances, starting with the 800m, and maybe (hopefully) even the 200m, my favorite distance. We’ll see - the key is to avoid re-injury.

Meanwhile, the myeloma is under control right now and life is very sweet.

Tuesday, December 05, 2017

Well, technically it's already winter season in Minnesota I guess, but you wouldn't have thought so last Saturday. 45 degrees, no wind, brilliant sun.

Looks greener in the summer :-)

On December 2 in the Twin Cities the average high temperature is 30 degrees, and in some years there is a foot of snow on the ground. Not last Saturday! The girls and I went to our beloved county park to run on the hilly grass and dirt trails, through meadows and deep woods.

I had a wonderful run, 6.24 miles in an hour and 22 minutes, for an average pace of about 13:28, running and walking. This weekend may have been the last chance to run in the park until spring, and plenty of other people were out there enjoying it too. I did aggravate the hamstring injury, sorry to say, but I had such a great time.
I took the selfie on a ridge that overlooks a huge native-plant meadow in the park, a favorite place to take a breather and enjoy the view for a moment. Sweet Pea took the second photo as I ran through the woods.

Today, Tuesday, the temperature is 17 degrees and the roads are icy. The drive from home to Mayo Clinic, usually about 100 minutes, took an extra hour. Alas, winter did get here.

Wednesday, November 22, 2017

Last June I competed in a USATF track meet. Apparently I pushed too hard, and pulled the right “proximal hamstring tendon.” I have seen my sports doctor at least twice and an excellent therapist many times, and mostly have followed their advice, but the injury persists. In fact the radiologist examining a PET scan in September found no significant myeloma lesions, but did report the hamstring injury as an “incidental finding.”

For now I’m walking and jogging, several times per week, trying not to cause pain in that injury. I had hoped that it would go away within a few weeks, as muscle injuries do, but it’s a tendon injury and it’s taking a LOT longer. I have no choice but to cool it until the injury is fully healed, and then to ramp up more carefully than I did in June.

We have a new place to do that. The local high school has recently opened a brand-new indoor walking/running track, priced quite reasonably. Nine laps per mile (very nice track!). We three have been there several times now, and lately I have been walking one lap and jogging the next, for a total of three miles, 27 laps. Next I could increase the distance to 4 or 5 miles, or increase the jogging to two laps, then three, until I can jog the whole three miles. Maybe I’ll do some of both. No hurry. We plan to be there several times a week, more as winter sends us indoors.

According to my therapist I should not run two days in a row, but I can walk all I want. In fact, we do walk from home to the co-op grocery and back every week, a hilly trek of six to ten miles, depending on the chosen route. We really enjoy those hikes, climbing back up the hills with groceries in our backpacks. We did one last Monday. It may have been our last for this year because we won’t walk those hills when the trails become icy, but I hope that we get a few more.

Wednesday, August 30, 2017

That's pretty much the bottom line from my sports doctor today. For more than two months I've been dealing with an injury of the right proximal hamstring conjoined tendon, at the point of attachment to the ischial tuberosity (i.e. where the hamstrings connect to the butt bones).

It seemed to be getting better and I had been running a little faster, without pain, taking 200m sprints at up to maybe 70-80% effort. Then suddenly about two weeks ago some part of the tendon connection failed during a sprint like that. Big ouch. Since then I haven't been able to run without pain at any speed, even though walking is pain-free. Instead, my girls and I have walked almost every day, about 25-30 miles per week.

I have not been able to find the injury by poking around in the area with my fingers, so my therapist (Katie) and I thought maybe it was the sciatic nerve, rather than the hamstring tendon. However, the doc said that the sudden mid-stride reinjury was not typical of an irritated nerve. More important, he did an ultrasound which seemed to show a dark region where the tendon should have been connected to the pelvis.

In the doctor's written report: "Diagnostic ultrasound imaging reveals a partial tear of the right hamstring conjoined tendon at the ischial tuberosity. Don should avoid sprinting for the fall months as I think this would put too much stress on the conjoint tendon. He is cleared for continued walking and jogging, as long as there is no significant increase in pain."

Since the normal condition is no pain at all, I understood this to mean that if it hurts I should stop, period. I plan to walk nearly every day, and test every time to see if it hurts if I jog. When it doesn't, perhaps I'll start doing a walk/run every day.

We three have a race next Monday, Labor day, called the MDRA Victory 10k, named after the neighborhood in which the race is run and after the beautiful Victory Memorial Parkway in Minneapolis. We have done this race many times, and it's a very nice, flat, out-and-back route. Further, it's one of the 13 Grand Prix events. I don't know how much of it I can run, if any, but I'm pretty sure that I can finish in the 90-minute time limit even if I have to walk the whole way.

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About Me

I have been running since 2002, and I enjoy everything about it. In 2003 I was diagnosed with multiple myeloma, a blood cancer with no cure. In 2008 doctors discovered that the myeloma was attacking my bones, but we are attacking it back, successfully so far. Running is a part of that, as well as a celebration of life. My sweetheart of 55 years and my daughter often run with me. Live one day at a time and make it a masterpiece!